We’ve all done it—given patients the standard advice to “increase your daily fiber intake” without a second thought. After all, it seems like a simple, harmless suggestion, right? But what does it actually mean to crank up the fiber, and when should you rethink the recommendation?
Halloween – a time filled with costumes, fun, and, for kids, a seemingly endless supply of candy. While it’s an exciting season for children, it can be a challenge for nurse practitioners caring for pediatric patients. The increased sugar intake can lead to heightened risks of cavities and tooth decay. As nurse practitioners, it’s important not only to understand the dental concerns associated with Halloween but also to educate families on how to manage the candy craze without sacrificing oral health.
Bacterial sexually transmitted infections (STIs), such as gonorrhea, chlamydia, and syphilis, are increasing across the United States. In June 2024, the CDC announced new recommendations for a novel approach to combat this rise by using doxycycline as post-exposure prophylaxis (PEP). You may be familiar with using PEP to prevent viral infections like HIV or pregnancy, but this represents a new public health strategy for bacterial infection prevention.
Feel that in the air? Yep, it’s fall sports season! But let’s be honest – these days, it seems like youth sports never really stop. With year-long practices, seasons blur together, and before we know it, our kids haven’t taken a break from organized sports in ages. While the physical and emotional benefits of sports are undeniable, the demands on young athletes are higher than ever.
As healthcare professionals, our days are filled with many tasks, such as patient encounters, documentation, and administrative work, not to mention keeping track of a household or family. Time management becomes crucial in ensuring that we provide quality care while maintaining our well-being. In this blog, we'll explore some valuable pearls for efficient clinical time management, and I’ll note some tips that have worked well for me.
Selecting the ideal suture material for deeper layers involves careful consideration since specific materials offer varying absorption rates, making them suitable for different wound depths. When speaking with Dr. Christina Shenvi on an episode of ERcast, Dr. Cohen recommended the following suture material options for closing the deeper layers of the skin (buried):
Fever in children is one of the most – and anxiety-inducing – concerns for parents and caregivers. While many pediatric fevers are harmless, some can signal more serious underlying conditions. A systematic approach to evaluating pediatric fever can help ensure that serious conditions are not overlooked. One effective method is to categorize potential diagnoses into three main buckets: Common Infections, Serious Infections, and Non-Infectious Causes.
The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for about six months, continuing breastfeeding for two years or longer as mutually desired by parent and infant. But with increasing diagnoses of tongue-tie (ankyloglossia) in recent years, conversations among pediatricians, lactation specialists, and parents have ramped up. So, what’s the deal with tongue-tie, and when does it really matter?
Hydrofluoric acid (HF) is a silent threat – seemingly harmless at first glance but with the potential to cause severe, life-threatening harm. It’s one of those rare exposures that many medical professionals may never encounter, but when it does happen, prompt and precise action is crucial. In this post, we’ll break down the crucial first five minutes after identifying an HF burn and the vital steps that urgent care professionals should take before transporting the patient to the emergency room.
Selecting the most effective antidepressant for patients can be a challenging process. Trial and error often leads to treatment delays, and no one likes to see their patients suffer through it. Enter pharmacogenetic testing – an approach designed to predict how a patient will respond to a particular antidepressant. But what is the science behind it? And more importantly, how reliable and practical is this in clinical settings?
Nowhere is the gap between book learning and clinical practice quite so apparent as in the world of pharmacology. The best medication for Diagnosis X is Drug Y on the boards, but what about when your real-life patient is allergic to that medication? What if they can’t afford it? What if there’s a drug shortage?
Our Hippo PAs had a great time at our Crack the PANRE-LA Code: Tips from the Pros webinar talking about our experiences taking the PANRE-LA. Here, we have reviewed some of the nuts and bolts of the exam and our top tips and tricks. We read through all the questions asked during the webinar and have also addressed some of those here. We hope this helps ease your test anxiety whether you are almost done, halfway through, or about to start the PANRE-LA exam. Regardless, Hippo Education has the tools you need to succeed.
Binge Eating Disorder (BED) is the most common eating disorder but also the hardest one to recognize in clinical practice. Often underestimated, BED affects a significant portion of the population yet remains underdiagnosed and misunderstood.
Emergency medicine often puts us face-to-face with lacerations requiring precision and care. Dr. Justin Cohen's visit to ERcast, alongside Dr. Christina Shenvi, illuminated the path to handling facial lacerations with the finesse of a plastic surgeon. Here are key takeaways to elevate your emergency room responses.
People take supplements for a variety of reasons, but typically, the goal is to enhance health. This month on Primary Care RAP, we dove into three supplements commonly used for heart health: Omega-3 Fatty Acids, Coenzyme Q10, and Red Yeast Rice. Curious what we found? Read on!
As I walk into the classroom to pick up my young child from school, I am greeted with a battlefield of zombie-like bodies strewn across the colorful carpet. I quickly scoop my son up off the floor, but my heart begins to race, thinking about that communal carpet, and I can’t help worrying about the possibility of head lice…
Ah, summer—the season of sun-kissed days and outdoor adventures. But all that sunshine comes with an enemy: sunburn. As urgent care providers, you're no strangers to the aftermath of a day spent under the rays. So, how can you best help your patients recover from sunburn and prevent further discomfort?
Picture this: You’re sitting on a white sand beach, enjoying the breeze in your hair and the bright blue skies. You take a deep breath, about to breathe in some much-needed vacation vibes. Suddenly, your phone pings. It’s a message from work. Your patient has an issue and needs your help.
It’s summer, and that is officially the season of the weekend warrior. You know who I’m talking about because you see them every week in your clinic. They decided to take on a new gardening project, a strenuous workout or tried water-skiing for the first time in decades, and now, a few days later they come to you with pain in their lower back.
-1.png)
In recent years, the landscape of cannabis accessibility has dramatically shifted, not just in conventional dispensaries but in everyday storefronts across the United States. This new wave of products, stemming from the 2018 Farm Bill's legal distinction between hemp and marijuana, has ushered in an era of synthetic cannabinoids like Delta-8 THC, Delta-10 THC, and THCA, which are finding their way into the hands of consumers and, inevitably, into emergency departments. As emergency clinicians, it's crucial to understand the implications of these substances, their legal ambiguities, and their effects on public health.
In the urgent care setting, we often encounter patients with ear pain, a common yet sometimes deceptively simple complaint. However, amidst the myriad of otitis media and cellulitis cases lies a less common and easily overlooked but significantly more serious condition: perichondritis.
Much like the classic "Schoolhouse Rock" episode, "I'm Just a Bill," we're here to explore how a vaccine goes from a brilliant idea to a lifesaving shot. In this discussion on Peds RAP, Sol and Dr. Paul Offit kicked things off with a playful nod to "I'm Just a Bill," reminding us of the catchy tune that taught us about legislative processes. But this time around, it's all about vaccines!
You've seen it countless times: a patient walks into the ED with chest pain, and the EKG isn't screaming STEMI. But in follow-up, they end up having a massive myocardial infarction. What is the hidden culprit lurking behind those non-alarming EKGs? Welcome to the Occlusive Myocardial Infarction (OMI) world, where traditional STEMI criteria fall short, and a new paradigm shifts our approach to acute cardiac ischemia.
As we enjoy the remainder of our summer but look ahead to the upcoming school year, it’s time to start thinking about those back-to-school physicals and routine immunizations for our patients and our own kiddos. In this blog post, we will offer insight into two current methods of offering HPV vaccinations to our youngsters and their parents/caregivers and discuss which method improves HPV vaccination rates.
It’s hard to help patients quit smoking. Many of us, myself included, received limited training in tobacco cessation and may harbor misconceptions about effective treatments. To clear the air, we invited Michael Baca-Atlas, MD, our addiction medicine specialist, to join us on Primary Care RAP to debunk some common myths about tobacco cessation. Here are some highlights from that conversation.
Insect bites and stings are a common nuisance during warm summer months when people spend more time outdoors attracting insects with their body heat, sweat, and odor . While most bites and stings are harmless, it’s important to recognize the potential for severe medical conditions. Here’s a breakdown of common insects and what you might expect from their bites or stings.
Gastroenteritis is a common urgent care diagnosis, but clinicians tend to default to it because they lack a better explanation for a patient's GI symptoms. Don’t fall into the same trap as a fellow urgent care provider from New York who missed a case of testicular torsion masquerading as a benign GI complaint.
As the parent of a tween girl, I'm acutely aware of the risks associated with her eventual exposure to social media. As a family, we have been holding out on a smartphone for as long as possible (we signed the Wait Until 8th Pledge). We also plan to follow the current recommendations to wait until age 16 for social media exposure.
As a physician in the pediatric emergency department, I see a surge in sports-related injuries with the arrival of summer and baseball season. Baseballs (and sometimes bats!) have a particular affinity for finding the pediatric eyes that make their way to my hospital. The eyes are one of those “black box” organs with their own language and pathology.
Is there anything more bread and butter in emergency medicine than intubating patients in high-stress situations? With five million adults needing emergency intubation annually, staying updated on intubation best practices is crucial. The PRagmatic trial Examining OXygenation prior to Intubation (PREOXI), just published in the NEJM and discussed on ERcast in this free segment, could revolutionize our approach to preoxygenation and, most importantly, improve patient safety.
Recently, one of my primary care patients sent me a routine question through the electronic medical record, asking when they should get a specific blood test to guide their medication dosing. When an hour went by and I hadn’t responded, my patient called the front desk of our clinic to ask the question over the phone and inquire why I hadn’t written back. They also wrote me another message, voicing their disappointment that I hadn’t responded to their question right away.
Every June, Men’s Health Month serves as a reminder to focus on men’s health, encouraging early detection and treatment of diseases. It aims to raise awareness about preventable health problems, promote healthy living, and encourage men to seek regular medical advice. In this blog post, we delve into the significance of Men’s Health Month and recommend essential screenings every man should prioritize.
Are you captivated by the adrenaline-filled environment of emergency medicine (EM)? You’re not alone. EM attracts 12.5% of PAs, making it a popular choice among advanced practice providers. But how do you get started in such a fast-paced, varied, and occasionally high-stakes practice environment?
In the ever-evolving field of urgent care, staying abreast of the latest knowledge and practices is crucial. We're excited to announce that we launched five new videos along with detailed written summaries focusing on common acute care injuries and procedures. These enhancements equip you with the advanced skills and knowledge necessary to walk confidently into your next UC shift.
In the high-stakes world of medicine, where every decision holds weight, the inevitability of human error can loom large over clinicians. It's a reality we all face, yet admitting our mistakes and grappling with their aftermath can be one of the most challenging aspects of our profession. How do we reconcile our desire for perfection with the reality of fallibility? How do we move forward gracefully and resiliently after making a clinical error?
Warm weather is here, and with it comes BBQs, longer days, and plenty of fun in the sun. Unfortunately, it also means more fishing hooks flying into unexpected places—including, occasionally, someone’s skin. This often presents a unique challenge for urgent care clinicians as we debate how to safely remove that stubborn hook and get our patients back to enjoying their day.
In primary care, we are seeing more and more patients using complementary or integrative medicine approaches. Understanding these treatment options and being able to counsel our patients about them is an important part of providing good care. But this can leave us wondering: What exactly is integrative medicine?
As emergency clinicians, the fast-evolving medical landscape challenges us to stay current with the latest knowledge and practices. We're excited to share the latest updates to our Hippo Emergency Medicine (EM) Board Review video course. These enhancements are designed to equip you with the advanced skills and knowledge necessary for excelling in your Board Examinations and daily clinical scenarios. These videos were created with the expertise of renowned educators, including Drs. Matt DeLaney, Emily Rose, Geoff Comp, and Drew Kalnow. Make the most of your time, have fun, and crush your test with high-yield, laugh-out-loud video education. Hippo EM Board Review is evidence-based, true-to-test education with a sense of humor.
Most new parents diligently child-proof their homes, installing cabinet locks, baby gates, and socket covers to safeguard their little ones. Yet, there’s an invisible hazard often overlooked—indoor air pollution.
Did you know that ticks can’t jump or fly? They simply lie and wait on the top edge of plants with their front legs stretched out. As soon as a warm-bodied being passes, they simply walk onboard. The practice is called “questing,” and it is the kind of knowledge that is perfect for your next water cooler conversation.
I’ve always appreciated having a friend with some strings they could pull. For years, we had a family friend who ran one of the most popular restaurants in town. I never fully appreciated their willingness to let me skip the line and a never-ending stream of free apps until they moved and a new owner took over.
Long COVID continues to perplex clinicians and researchers alike. With its myriad symptoms and unpredictable course, it's no wonder it's been frustrating for both patients and healthcare providers. While the prevalence seems to be declining, it still presents significant challenges, often lingering for weeks, months, or even years after the initial COVID-19 infection.
Her scream reached a pitch I had never heard from her before. It was nine in the evening, and she was playing with her sister, engaged in lively roughhousing before bedtime. When I hurried out of the kitchen, I found her lying on her back, clutching her leg, and there was no mistaking a patellar dislocation. Without hesitation, I switched into urgent care mode, aided by my husband, and successfully reduced her patella. Seeing a dislocated patella is always visually unsettling, whether it’s your first time or not.
The importance of multilayer closure in a laceration repair cannot be overstated, with techniques like buried dermal closure and strategic skin closure options enhancing both functional and aesthetic outcomes. Dr. Justin Cohen made a guest appearance on ERcast, where he joined Dr. Christina Shenvi to discuss his techniques for repairing facial lacerations as a plastic surgeon. He went into great detail about repairing deep forehead lacerations in the emergency department, and here are some of the techniques he discussed.
The choice between absorbable and non-absorbable suture materials for skin closure hinges on various factors, including patient comfort, follow-up availability, and ease of removal. During a recent appearance on ERcast, Dr. Justin Cohen discussed his plastic surgery approach to repairing facial lacerations with Dr. Christina Shenvi. Here are some key takeaways from Dr. Cohen for selecting suture material for closing the skin surface:
Spring is one of the worst seasons for seasonal allergy sufferers. Patients with seasonal allergies will commonly complain of runny noses, congestion, itchy, watery eyes, and sneezing. However, a chronic cough and sinusitis can also be caused by allergies.
Last month, while editing an audio segment for Urgent Care RAP on eustachian tube dysfunction, I learned about a medical condition I had NEVER heard of. Not only was it new to me, but it also immediately ascended to my list of greatest fears, ranking in third place just below waking up with a spider in my mouth.
The buzz around hormone therapy for cisgender women is undeniable, with a surge of interest in testosterone. Big shoutout to Emilie, one of our astute RAP listeners, for spotlighting this topic! (Psst, you can also listen to us unpack this further on Primary Care RAP’s April episode).
Whether you’re fresh out of your medical program or a seasoned urgent care veteran, the moment a child steps through those doors, the stakes feel different. Does deciphering pediatric ECGs and plain films feel like decoding a complex puzzle? You’re not alone. That’s why, in partnership with Urgent Care Association, Hippo Education designed the Urgent Care Peds Bootcamp, your go-to video course for enhancing your pediatric care skills in urgent care settings. Created by a team of pediatric emergency medicine doctors and board-certified pediatricians, this course bridges the gap between pediatric expertise and the fast-paced world of urgent care, so you’re prepared for whatever comes through your doors.
As an urgent care PA and a mom, there isn’t much that scares me. My kid could eat a fistful of dirt, and I wouldn’t bat an eye. But there is one thing that makes me jump faster than a small child standing next to my bed at 4 am telling me they have a tummy ache…button batteries.
How do we know if we (or our new-hire clinicians) are ready to practice urgent care medicine independently? Did you recently graduate from school or switch from another field of medicine, or are you in charge of hiring these new clinicians? The Urgent Care Clinical Readiness Assessment is the answer.
Welcome, fellow PAs, to the PANRE-LA journey; whether you are about to start quarter six or quarter 2, we are all in this together. I am about to begin my 6th quarter and wanted to share some tips and tricks learned over the past five quarters that can help you succeed.
You're in the clinic and about to walk into a room to see a patient with a non-specific chief complaint like dizziness. In your head, you know the dizziness could mean something benign and self-limiting or emergent and life-threatening. You know you learned about the HINTS exam in your training, but now you're questioning if a positive head impulse is good or bad. You're starting to think, "Gosh, do I know anything? Why did these people hire me?" If you relate to this, you may have experienced imposter syndrome.
We experience a lot of transitions in life: childhood to adulthood, in and out of relationships, change jobs or roles. Transitions can be planned or spontaneous, exciting or terrifying, easy or hard... or a combination of them all!
As pediatricians, we’re trained to take care of everyone else. We care for our patients, their parents, our staff, specialists, and our community. Many of us were drawn to Pediatrics because we’re naturally empathic and enjoy solving problems. But it can be hard to maintain that core sense of mission and joy when we’re dealing with anxious parents, bureaucratic obstacles, clunky EHRs, sick children, and personal life stressors.
After residency training, the ABEM Oral Board Exam is the second major hurdle in becoming a board-certified Emergency Medicine physician. While the pass rate is high (~91% in 2023), examinees must be ready to play the game by ensuring they know the format, standards, and rules. ABEM offers the virtual exam twice yearly; the 2024 dates are April 16-19, 2024, and September 10-13, 2024.
When the clock strikes midnight on New Year’s Eve and 2025 is ushered in, PA students everywhere will also usher in a new era as NCCPA just released the new PANCE Content Blueprint. Here is what you need to know about the changes to help you prepare for your exam if you take it in 2025 and beyond.
Have you ever wondered if that 4th case of acute diarrhea and vomiting that you saw during your last shift in the urgent care may be related to the others? Have you ever seen a kid with a rash, and the thought of measles crossed your mind?
In the realm of pediatric sleep management, melatonin has emerged as a popular yet contentious tool. As healthcare providers dedicated to the well-being of our pediatric patients, it's essential to understand both the potential benefits and risks associated with melatonin use. In this blog, we'll explore the latest recommendations and guidelines, along with practical insights to educate parents on the use of melatonin in children.
Eating disorders are often misunderstood, sometimes overlooked, and tragically underestimated in their severity, especially in the healthcare setting. Contrary to common misconceptions, they are not phases or lifestyle choices but rather serious, biologically influenced illnesses. With an estimated 28 million Americans grappling with eating disorders, it's crucial to recognize that these conditions are far more prevalent than once believed.
In the fast-paced world of emergency medicine, healthcare professionals are often viewed as unsung heroes, tirelessly working to save lives in high-stress situations. However, behind the scenes, a silent struggle persists—one that is often overlooked and stigmatized. Physician addiction is a complex issue that demands our attention and understanding.
The recent explosion of GLP-1 agonists has led to an increase in the number of patients asking about medication for weight loss. Although you may be happy to encourage patients to achieve their weight loss goals, you may also wonder about the best ways in which to support them.
Does anyone else find themselves relying heavily on your EMR system's medication interaction checker when prescribing medications or considering medication management? If you're like me, it’s a vital part of my workflow.
Talipes equinovarus, the Latin term for clubfoot, is the most prevalent congenital musculoskeletal anomaly worldwide, affecting approximately 1 in 1,000 newborns. A majority of clubfoot burden impacts low and middle-income countries, underscoring the global health disparities in access to early intervention. If left untreated, this condition can lead to significant deformities, emphasizing the critical role pediatricians play in timely diagnosis, management, and treatment of clubfoot.
As an emergency medicine resident, preparing for the ABEM In-Training Exam (ITE) is a pivotal phase in your medical journey. This high-stakes exam not only assesses your knowledge and readiness for the next steps in your career but also lays the groundwork for your lifelong practice in emergency medicine. While there is no “passing” score for the ITE, studies and empirical data have shown a strong correlation between test results and performance on the ABEM written board exam. Physicians with higher ITE scores have a higher likelihood of passing the ABEM Qualifying Exam than those with lower scores. The ITE helps identify areas of weakness early in your residency training. Addressing these areas promptly can significantly improve your chances of passing the board exam on the first attempt.
Have you ever been asked about ashwagandha? Or had a patient who prefers valerian root over trazodone for sleep? In the ever-evolving landscape of healthcare, patients frequently turn to dietary supplement use to address a variety of health concerns. As healthcare professionals, it is our responsibility to guide our patients with evidence-based recommendations while also supporting their holistic well-being. However, most of us have had little or no training on the risks and benefits of the various dietary and herbal supplements on the market.
As we celebrate American Heart Month, let’s take some time to review all the different ways our heart valves can break and how they present in the clinical setting. Ok, “break” is dramatic, but it’s February, when all sorts of heart puns are forgiven, right? ❤️
Have you ever wondered what goes on behind the scenes at a medical education company? Hippo Education makes video, audio, and written medical education, and we make a lot of it! If you wonder what makes us different, the answer, in short, is: practicing clinicians, peer review, and a crazy fun team.
Shave and punch biopsies are essential procedures for those who manage skin conditions and skin diseases. They can provide helpful information about undiagnosed skin lesions such as neoplasms, bullous disorders, keratoses, or dysplastic nevi. A diagnostic biopsy can also be the definitive treatment for malignant, irritated, or precancerous lesions. There's a right and a wrong way to do things, though. Here are our top 10 tips to prevent errors during skin biopsies.
Conversations in the emergency department can be challenging, especially when we need to say "no" to patient requests. Let’s explore why this is difficult, the importance of having a script, and a framework for handling these conversations.
The holidays may be over, but ‘tis still the season for slip and falls on the ice that result in tailbone and coccyx area injuries. Coccyx injuries are a common chief complaint in urgent care during this wintery, icy time of year. Classic coccydynia (aka coccyx pain) is worse when sitting and can worsen when rising from a seated position. At first glance, this seems like a straightforward chief complaint, but it lends itself to opportunities for a more nuanced discussion with patients.
As we usher in a new year, we find ourselves at the forefront of healthcare, continuously providing vital services and compassionate care to those in need. Amidst the challenges of the ever-evolving healthcare landscape, we must remember that we, too, deserve care and attention – not just for the sake of our well-being but also for the benefit of those we serve. According to an article published by the Journal of General Internal Medicine, nearly half of healthcare professionals are burned out. Burnout among healthcare providers has been shown to negatively impact patient safety, quality of care, and patient satisfaction. This new year presents a golden opportunity for us to prioritize self-care, fostering a healthier and more resilient healthcare workforce.
Tens of millions of people in the United States have trouble accessing the healthcare services they need. Whether for lack of housing, insurance, or transportation or because of language and literacy barriers, there are so many reasons why people who need medical care may not be able to reach us. Or when they do, we may not always know how to help. As front-line clinicians, we can play a role in helping our vulnerable community members. This is especially true for those of us working in urgent care.
In this month’s episode of Peds RAP, we discuss the case of a two-year-old child that presented with a history of constipation and abdominal distention. The journey to diagnosis uncovered a complex medical condition - Hirschsprung’s Disease.
As December is Safe Toys and Gifts Awareness Month, now is the perfect time to emphasize the importance of toy safety to parents and caregivers.
Toys bring joy and learning opportunities to children, but they can also pose serious health risks. According to the United States Consumer Product Safety Commission’s (CPSC) report on Toy Related Deaths and Injuries in 2022, there were 11 deaths in children under age 14 related to toys.
There were also 209,500 emergency department visits due to toy injuries in those under age 14, with 38% of those injured being young children under age 4. Many toys can cause minor scrapes or cuts and according to the U.S. CPSC report, 41% of the ER visits due to toy injury were for lacerations or bruising in 2022.
-1.jpeg)
Hundreds of thousands of people in the U.S. experience homelessness, and those individuals face unique barriers when they come in to see us for medical care. Learning to ask the right questions, while using a trauma-informed approach, can help us better treat our patients. One tool to remember: HOUSED BEDS.
In the dynamic world of Emergency Medicine, staying up-to-date with the latest clinical guidelines is essential to providing the best possible care for our patients.
The American College of Emergency Physicians (ACEP) has recently released updated guidelines that directly impact our practice in the management of ischemic stroke care, suspected appendicitis, mild traumatic brain injury (mTBI) in adults, and acute heart failure syndromes.
With this update, ACEP is collating the results of recent articles, plus providing expert synopsis and commentary in an effort to drive good patient care forward on some really important topics. Let’s explore these updates and their implications for emergency providers.
Ah, pneumonia – the not-so-welcome guest that always seems to overstay its welcome. But what happens when pneumonia lingers? Do we whip out the trusty X-ray machine for a follow-up, or do we cross our fingers and hope for the best? Today, we're diving into the mysterious waters of follow-up imaging after pneumonia.
As clinicians practicing acute care medicine, we’re tasked with treating a wide variety of patients.
And no matter how thorough our didactic education or clinical skills training, many of the tools we use in acute care medicine are learned on the job.
And there’s no better example of this than plain films interpretation. Unfortunately, this leads to wide variances in both imaging study experience and imaging interpretation accuracy amongst providers.
One of the biggest challenges for any PA moving to another state is the need for a new state license. This is especially true for active-duty PA military spouses due to their frequent moves. This uprooting not only personally affects couples and families, but also the patients, clinical teams, hospital systems, and communities due to turnover and loss of clinicians in the workforce as these PAs relocate.
Consider this. You’re working your next shift and it’s a busy one. The waiting room is full and you haven’t even had a chance to eat lunch.
While trying to disposition that patient with hematuria and back pain, you quickly glance at their CT scan and then review the radiologist’s read. Boom, kidney stones, just like you thought. But, as you continue to scroll through the entire reading you come across the dreaded incidental finding of a pulmonary nodule. What do you typically do with this information?
We’ve all been there; you look at your schedule and see a patient with a chief complaint of “dizziness.” Cue the sense of dread!
EM PAs are increasingly becoming a critical part of the house of medicine. Last month, we explored how the EM PA profession evolved and what it takes to become an EM PA. This month, we dive into the diverse settings an EM PA can work in and what that looks like.
The ABEM Qualifying Exam is coming up: October 30 – November 4, 2023. Are you ready? Preparation requires discipline, effective study strategies, and a comprehensive understanding of the material. We compiled a list of 7 study tips for the ABEM qualifying exam:
Right now, you’re likely providing more mental healthcare to your patients in your outpatient clinics than ever before.
Writing about a day in the life of an emergency medicine PA only paints a small picture of what it truly takes to become an EM PA. A “typical” workday will look entirely different for every PA due to the nuances of the ED setting and the part of the ED a PA is assigned to. So, our goal here is to paint a full picture of the many facets of working as a PA in emergency medicine and to demonstrate what makes us an integral part of the team.
Before we dive into what it looks like to work as an EM PA, let’s explore how the profession evolved in the first place - and what it takes to get into this field.
In the fast-paced world of urgent care, PAs are indispensable. This PA Week, we highlight the remarkable opportunities for professional growth and development for PAs within the urgent care space, both inside and outside the exam room.
Breast cancer screening can be complicated; sometimes it’s more than just a mammogram. For example, when a screening mammogram report says a person has dense breasts, what does that really mean? Why is it important, and what should we do about it?
As clinicians it’s critical that we understand the drugs our patients are using and can identify their side effects, but it can be tough to keep up.
An emerging threat across the country is the use of xylazine, or “tranq.” Xylazine is an animal sedative, muscle relaxant and analgesic with a potent central nervous system depressant effect in humans. This tranquilizer is frequently added to various drug mixtures sold on the street. Tranq can be found across the U.S. – the Drug Enforcement Administration reports finding it in 48/50 states — and last year almost one quarter of the fentanyl the DEA seized contained xylazine.
Can you be a good steward of antibiotics and maintain high levels of patient satisfaction? It depends!
As we move into cold and flu season, we know the number of patient antibiotic requests will be on the rise.
We all know the importance of antibiotic stewardship and the impact of inappropriate antibiotic use. We also know the significance of patient satisfaction, especially in urgent care medicine. This begs the question: Can you be both a good steward of antibiotics and maintain a high level of patient satisfaction?
We recently asked our Instagram followers whether or not they felt like antibiotic prescribing was linked to patient satisfaction. Here’s what they said:
Treating acute pain is a challenge we face during every urgent care shift. We’re all aware of the devastation that the opioid crisis has had on millions of people worldwide. And this epidemic - marked by addiction, overdose, and unintended consequences - has highlighted the need for alternative treatments to manage pain.
As clinicians, we regularly encounter patients wanting or expecting opioids to treat their pain. For years, opioids were the go-to option. We’ve since learned that even short-term opioid prescriptions can lead to tolerance, dependence, and addiction, making them a potentially risky choice for pain management.1 However, not all providers are comfortable or possess the knowledge to discuss safer and more effective alternatives to opioid medications.
With Fall comes the start of cold and flu season. Whether you work in a family medicine clinic, urgent care, emergency department, pediatric office, or specialty clinic, you can’t escape the nasty viruses that cause upper respiratory infections and wreak havoc on our immune systems.
If you’re on the frontlines of the emergency department, you’ve probably noticed the uptick in respiratory infections and viruses in the early kick-off to 2023’s respiratory season.
As we brace for fall and winter, it looks like we’ll have additional tools in our arsenal to decrease complications and hospitalizations from respiratory syncytial virus (RSV): adult vaccines and a monoclonal antibody for all infants.
Three different vaccines will be available this season to combat viral respiratory symptoms and threats:
Additionally, there will be another RSV monoclonal antibody option for our tiniest patients. Phase 3 trials and regulatory approval are underway for maternal vaccines and passive immunity protection for newborns.
Let’s dive into these tools now.
In our May blog post, we introduced you to the CARE acronym (Common, Atypical, Rare, Emergent) to help students formulate differential diagnosis. Over the next few months, we want to apply the CARE acronym to some chief complaints. We hope this will be helpful to you as you’re precepting students. Share this blog post and graphics with them during their next shift!
We are all learning how to be good stewards of prescription opioids which has resulted in a significant downward trend in dispensing rates over the past decade. However, the number of fatal overdoses due to fentanyl continues to rise.
Everyone’s buzzing with the news of the DEA’s new opiate training requirement for healthcare providers. That’s right - as of June 27th, 2023, any physician who applies for DEA renewal needs to certify completion of an 8-hour, one-time training on the treatment and management of patients with opioid or other substance-use disorders.
The countdown to October is on! You’ve already applied for the American Board of Pediatrics General Pediatrics Certifying Exam and are probably in the midst of studying.
As clinicians, many of us have been touched personally as well as professionally by the opioid crisis and overdose deaths. According to the CDC, over 107,000 people in the U.S. died of drug overdoses from January 2021-January 2022, and 67% of those deaths involved synthetic opioids such as fentanyl. Fentanyl is especially terrifying because many people who overdose on it may have had no intention of using it at all.
As most of us are now aware, the US Department of Justice created a new opioid-related training requirement for DEA-registered providers. This new requirement went into effect June 27, 2023 for those renewing their DEA license.
The requirement is 8 hours of training (CME not specified) regarding opioid use disorder and other substance use disorders. There are two main exceptions to this requirement:
It’s August, which means sports physical season is upon us. Organized sports are an important way for children 6 and older to meet the recommended 60 minutes of physical activity per day. However, it’s important for clinicians to use the sports or pre-participation physical examination (PPE) to identify who can safely participate in these activities and who needs further evaluation before they are cleared to participate.
By Jen Swisher, PA-C and Geoff Comp, DO
Summer is here - and we know all too well that drowning and water-related medical emergencies rise during this time of year.
As emergency medicine providers, we all have one degree of separation from a tragic story of a submersion event. While we’re well-versed in the in-hospital care of a drowning victim, it’s possible that we may also have to play the part of first responder at home, the pool, river, lake, or beachside.
Are you ready to take action outside of the ED? Matt DeLaney, MD and Geoff Comp, DO are.
Have you ever heard a doctor from one specialty bash or badmouth another specialty? We have, too. Specialty disrespect is a form of microaggression in the health care community, and it has a real impact on students, residents and our patients. But we have the power to change the culture, and it’s time to address this issue.
Chances are, unless you’ve been living on a remote island somewhere, you’ve heard about the obesity guidelines published by the AAP in February of this year. These are the first clinical guidelines on obesity management and treatment in children, and they’re not without controversy! While some have applauded this publication as long-overdue, others worry about overreach and unintended consequences.
In early April, the US Department of Justice sent out an email notifying clinicians of a new opioid-related training requirement for DEA registered-providers. Over the past several weeks, there's been chatter on social media and discussion boards about what this new training is, who needs it, and how to fulfill it. We're here to share that we're working on OUD Decoded: A DEA-Compliant Audio Course and will make it available by July 2023!
Our team dug through the internet (and read through the entire MATE Act 🤓) to deliver you the information below.
Understanding the signs and symptoms of cataracts is essential for accurate diagnosis and appropriate treatment planning. Let’s explore the key indicators that can help us as medical providers to identify and address cataracts effectively.
We know that chronic hepatitis B infection can lead to substantial morbidity and mortality. While there is no cure, antiviral treatment, monitoring, and liver cancer surveillance can improve outcomes for people living with hepatitis B. Additionally, effective preventative hepatitis B vaccines are available.
Until recently, guidelines recommended that only people at high risk of infection be screened for hepatitis B virus (HBV). Under that policy, we missed a lot of people: only an estimated 1 in 3 people in the U.S. with hepatitis B are aware they are infected.
As the role of urgent care clinicians continues to expand in the house of medicine and we take on more responsibilities, it’s our job as clinicians to ask ourselves:
When my daughter was diagnosed with PFAPA (Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Adenitis) syndrome, I wasn’t surprised. I myself had suffered from a mysterious recurrent fever in my childhood, and at some point in medical school, I pinpointed PFAPA as the most likely cause.
But I was surprised to discover just how common it actually is. Did you know that PFAPA is the most common type of recurrent fever syndrome in children?
As primary care clinicians, we play a crucial role in helping our patients make healthier food choices. But with all the contradicting information out there, sifting through nutrition evidence can be daunting.
One diet that has evidence for helping prevent disease and promote better health is a whole-food, plant-based diet.
This diet focuses on eating whole grains, fruits and vegetables that have undergone minimal processing. Studies have shown that this approach is associated with health promotion and disease prevention, and that a plant-based diet is a cost-effective, low-risk intervention that may lower BMI, BP, HgbA1c and cholesterol levels.
As Michael Pollan says in his book In Defense of Food: “Eat food. Not too much. Mostly plants.”
PA Students, the clinical rotation year is an exciting and challenging time, as you’re finally able to apply all that you’ve learned in the didactic year to real-world patients. On the other hand, this year is also stressful and can feel overwhelming with all the changes and newness.
For over a decade I’ve been on PA faculty, and every year, the start of the clinical year brings up the same emotion in all of my students. I think the proper word for this emotion is “scited,” which was coined by author Glennon Doyle and is the combination of “scared” and “excited.”
All of my students ask the same questions… “What are my rotations going to be like?” “How do I not look like a doofus on the first day?” “What kind of questions are preceptors going to ask me?” And then, of course, the classic question, “What is going to be on the test?”
My Hippo PA team understands what it is like to feel “scited” about this year, because we’ve lived that experience, and walked hundreds of students through it.
Here’s my advice:
Hippo has been a longtime partner of the Urgent Care Association (UCA), the trade association that represents Urgent Care clinicians and business professionals. We’ve worked together on several projects over the years, and this year we worked on two new projects: Urgent Care MA Bootcamp, a video-based onboarding program for MAs, and “Hippo Live at UCA”, a dedicated clinical track during UCA’s annual convention. While we are pros when it comes to creating video content, this was the Urgent Care team’s first time putting on a live event. And while it was a lot of work, it was a fantastic experience! If you weren’t able to attend live, here is a brief recap:
Cancer screening is a critical part of primary care practice, and most of us can recite guidelines in our sleep. That said, cancer screening can feel a little tricky in our transgender population, especially when we are still learning to navigate this sensitive topic as a general part of our practice.
When helping primary care patients navigate heart disease prevention, we all know the big interventions to cover: quitting smoking, exercising, and eating a healthy diet with more plant-based foods. But are you also covering these less prominent risk factors?
As PA-Cs everywhere are starting the 1st quarter of the new PANRE-LA, we know anxiety is high. Five minutes seems like a long time when we are watching our favorite sports team try to come from behind or desperately try to hold on to the lead. But when that PANRE-LA timer starts to tick down, five minutes a question doesn’t seem that long at all. And we know that panic can set in quickly with each passing minute.
What’s the secret sauce that makes Hippo Education’s urgent care products so popular with 150 provider networks and leading to a partnership with the Urgent Care Association?
It all starts with our educational philosophy.
Are you deciding if the PANRE-LA is right for you? Have you already signed up for it? Let the PA team at Hippo Education help you feel confident as we all approach these uncharted waters together.
I am very proud of Hippo’s Race and Medicine series and its efforts to foster a rational discussion around an important topic.
Our CEO Aaron Bright, MD, sat down to discuss the remarkable way in which Hippo’s giving back where it really counts this holiday season.
In this bonus content of AAPA Primary Care RAP, our hosts Adrian Banning DHSc, MMS, PA-C, DHSc and Kris Maday MS, PA-C, DFAAPA chat with AAPA President Jennifer Orozco, who discusses her journey from being a PA in Chicago to becoming the leader of the AAPA, and even shares her insights into how to balance your own wellbeing while taking care of the wellbeing of others.
Join us for a Q&A with emergency physician/Hippo CEO Aaron Bright as we pick his brain on one of the biggest issues in modern clinical practice.
Your clinical year will be one like no other that you have ever experienced. Changing rotations every two, four, six or maybe even eight weeks is a lot of change. Some of you will be moving physically to new places for each rotation which adds the extra stress of packing, driving, maybe even flying and settling into new digs right as you start a new rotation. It can be a lot.
I graduated from PA 17 years ago in 2004 and that year only one of my classmates did a post-graduate residency and it was kind of by mistake. She followed a fiancé far from home, hated her first job, and took a dermatology residency spot out of necessity when her engagement broke up and she had a lease in a city with no job. She ended up loving dermatology and still practices it to this day. Residencies were just not commonplace ‘back then’.
You’ve passed your PANCE (Congratulations!!!), landed your first job as a PA, and now it’s time to start focusing on maintaining your NCCPA certification. Part of that process is obtaining and logging continuing medical education (CME) credits. When I first graduated, it was hard to keep straight the different types of CME credits. How do I know if an activity counts as Category 1 or 2? What the heck is the difference between Category 1 and Category 2? What records do I need to keep in case I get audited by the NCCPA? Wait, I can get audited...like the IRS audits taxes?!
You’re about to graduate from PA school and enter the job market. Congratulations! Time to craft your resume, a rite of passage as a professional. Maybe you’ll dust off those cobwebs from an old resume, or create a new one from scratch. But where do you start? Googling “How to write a resume” will return an endless number of (maybe helpful) results. But, if you’re anything like me, I still had questions like, “Do I include my previous job experience, like before PA school?” or “Do I include my clinical rotations?” I was fortunate to have a wonderful staff member at my PA program that helped me write my first professional resume. So, let me pay it forward to you all.
If you’ve listened to our audio series, you’ll know there are several things that make my palms start to sweat. Presentations on rounds. The first day of a new clinical rotation. Mariachi bands. Well, here’s another one: job interviews.
Carbon Health’s growth is off the charts—they are adding 60 new urgent care clinics this year, with projected five-year growth of 5,900%. Roger Wu, Medical Director at Carbon Health, discusses how a key to the organization’s success is Carbon’s commitment to clinician education and career development. Through a partnership with Hippo Education, Carbon’s culture of lifelong learning has fostered a clinician retention rate of 95% that continues to fuel their success.
Urgent care centers represent a vital component of the American health care system, as evidenced by their rapid growth over the last decade and urgent care’s role during the COVID-19 pandemic; but demand for urgent care services has highlighted a need for focused education for the clinicians practicing in this nuanced environment. By equipping clinicians with specialized urgent care education, urgent care centers can better support their teams and improve patient outcomes.
My specialty is Emergency Medicine but I think the following sentiment applies to all clinicians: doctors, PAs, NPs, nurses, techs… the whole team.
Do you remember, in school or in residency, when you made a great diagnosis, did some cool procedure, or saved the day in some way? What happened next? High fives all around, proud mentors, stories at rounds, teaching peers how you did it, drinks after work… good times.
With clinicians from different specialties and experience levels, onboarding for urgent care can be challenging. These tips will help you prepare your clinicians for the urgent care setting, so they’re equipped and confident from day one.
I’m a thinker. I don’t mean in the Socrates kind of way. I just mean that if you present me with a new problem my brain tends to go deep on it right away. I start thinking of nuance and options and outcomes and before I know it I’m underwater in data and ideas. This can be paralyzing for me if I don’t get back to the surface. See for reference: choosing a medical school, deciding to leave community practice for academics, and whether to get that full-back unicorn tattoo.
With the help of the Hippo team I started a monthly(ish) newsletter. If you’re a medical practitioner please check it out. I hope to bring some good stuff for you each month.
I’ve had a personal morbid fascination with the medical literature since medical school. I’ve lived long enough to see several things be portrayed in the professional and layperson literature as miraculously beneficial treatments only to be the polar opposite in the next study or after failing to be replicable long term. It’s nuts. I’m not a statistician but I’ve been trying to become more facile with statistics (I highly recommend this amazing little book) and especially the many kinds of bias that can influence the “conclusions” of studies.
The good physician knows his patient through and through, and his knowledge is bought dearly. Time, sympathy, and understanding must be lavishly dispensed, but the reward is to be found in that personal bond which forms the greatest satisfaction of the practice of medicine. One of the essential qualities of the clinician is his interest in humanity, for the secret of the care of the patient is in caring for the patient.” -Dr. Francis Weld Peabody, 1927
The Hippo Education crew took a well-deserved retreat to New Orleans this past week. As a remote company we treasure the opportunity to come together IRL. The company was wonderful, the city fascinating, and the beignets plentiful.
I have had a task on my to-do list for forever, inspired by all kinds of deep people, to write thank you notes to people who had a profound impact on my life. I don’t know why I never get to it. But, the other day I did one. I happened upon the email address of a doctor named Rinaldo Canalis. I’d been looking for a place to send him a note that wouldn’t get thrown away (like a hospital address might) for years.
A few weeks ago I woke up with that strange feeling of health and energy that comes from the absence of discomfort. After an epic 10 day trip to Indonesia focused on surfing in an environment at times paradise-like and at times very polluted, I got slapped down for a week or so by a combination of jet lag and some sort of severely crampy GI bug. The first morning I woke up not feeling horrible, felt amazing.
I am Aaron Bright and I am an emergency physician and the CEO and founder of Hippo Education. You can find out a little more about me here.
Sign up for our Newsletter!
©2024 Hippo Education LLC, part of Colorado Technical University. – All rights reserved.
An Interview with PAs 
